When it comes to big organizational changes, consulting with physician leaders is a critical factor for short-term and long-term success. “I have seen physician engagement serve as an essential ingredient for any major initiative that’s being developed and ultimately implemented by a health system,” says Medical Advantage Executive Consultant Monty Pate, our guest for this episode.
Every decision is consequential to the success of a health system. When project managers or private equity firms move ahead without input from physician leaders, they lack key information to make the best-informed decisions. Enlisting physician leadership is a beneficial change agent for the direction of major change.
When should you approach physicians for insights? Which physicians should you approach and how should you approach them? In this episode of the Medical Advantage Podcast hosted by Technology Consultant Celina DeFigueiredo-Dusseau, we answer all these questions and provide guidance on how to navigate this invaluable relationship with physician leadership.
Monty Pate covers the intricacies and best practices regarding this cooperative relationship, plus real-world examples of the effectiveness of physician leadership.
Thank you for listening to the Medical Advantage Podcast, where each we take time each episode to discuss the ideas and technologies changing healthcare, and the best practices your organization can take to stay productive and profitable. Subscribe wherever you get your podcasts to ensure you never miss an episode.
Key Takeaways from Podcast Episode 33 Recruiting Physician Leadership for Health System Success
What Physician Engagement Is
Physician engagement involves a “physician champion” who provides influential insight and serves as a voice in the interests of his or her peers. This is a partnership role for the development and rollout of initiatives – particularly transformational projects.
This can include a wide variety of undertakings; anything from new EHR implementation, construction projects, compensation models, consulting or private equity engagement, patient workflow, and even provider recruitment.
The Role of a Physician Champion in Modern Healthcare
Physician engagement serves as an essential ingredient for any major initiative being developed with the end result of being implemented by a health system. Essentially, the role of a physician champion is a change agent that can create momentum and bring about a cultural alignment to support the initiative.
What Health Systems Should Look for in a Physician Champion
Ideally, when seeking a physician to engage, you’re looking for providers who have a broader understanding and appreciation for all the elements that make up the healthcare enterprise. To be effective in this role, the physician should have a firm understanding of budget, staffing, patient engagement, brand loyalty, informatics, compensation models, quality, telehealth, etc. This role is best for a physician with a global perspective with regard to healthcare.
Aside from experience, this role is best suited for someone willing to be part of the solution and work with other stakeholders in a truly collegial and collaborative manner. This can manifest either by being part of committees or working groups. This physician should be willing to provide input that is frank, honest, and constructive. At the same time, he or she represents the overall best interests of the health system.
Finally, you want to find physicians who can garner buy-in. This means the physician is well respected amongst their peers, but also is willing to communicate at the peer-to-peer level to introduce the strategies and initiatives being developed. It is also beneficial to engage with providers from diverse practices, i.e., primary care and specialty care.
Why Physician Engagement is a Unique Leadership Opportunity
Because providers are so closely involved with the delivery of care, they bring a unique perspective as to the initiative’s impact down to the patient level. Also, a provider advocate or champion can really bring credibility to the project. It’s one thing for C-Suite or administration to talk about initiatives or plans, but to have a physician champion who is aligned and supportive of those plans only helps to align the organization in the long run.
By their nature and training, providers want to understand the “why” behind any given project, and this is another benefit because consultants and administration must then articulate the “why” behind what they’re doing. Another aspect to consider – and sometimes this can be a little painful on the front end – is that by their training, providers will look to challenge gaps in logic. They challenge assumptions, which really forces the stakeholder to reconcile these concerns early in the process and that is ultimately a positive thing.
On the flip side of this, if you fail to engage your providers, this may generate a rumor mill within the organization if they’re not sure what’s occurring or why it’s occurring. This is just human nature to have a fear of the unknown. It also can erode morale when input from physician champions isn’t called upon for consideration. Providers as a group also want to be heard and they want to know that their input matters. When you neglect to engage your providers, you’re really missing out on that critical provider perspective.
Where to Begin in Developing a Physician Engagement Strategy
Start with the C-Suite; CEO and COO. Your C-Suite should know which providers are collaborative by nature, as well as the ones that see the big picture of healthcare enterprises.
The folks in the front office should know their provider team and know not only who the formal leaders are within the organization, but also the informal leaders. Informal leaders may not have a formal title, but they are the ones whom the other providers and staff look to.
Finally, you want to leverage that C-Suite knowledge in terms of identifying providers who want to be part of the solution. What you really need are providers who – rather than just criticize – will roll up their sleeves, be a part of the solution, and come along on the journey. Begin these discussions at the conceptual stages of any initiative so it is done early on to assess a willingness to participate.
Real Example of How Physician Engagement Fostered a Positive Outcome
The leadership for a health system in the south – that is part of a large hospitalist group – was looking for a way to incentivize hospitalists to support the system’s quality goals. The administration communicated the “why,” which is to move the needle on the quality outcomes. The reason being the administration realized that hospitalists have a great impact on inpatient quality.
They were also looking to create a physician compensation model and bonus structure. The idea was to tie such incentives to quality metrics that aligned with the system’s quality initiatives. The intent was to create a win-win, a win for the providers and a win for the system.
The hospital leaders received the directives in a very well-laid-out, articulated way. The first thing that the hospitalist leadership did was to solicit input from all the providers on their team. This consisted of a group of about 80 or so hospitalists spread out over 4 different campuses. Then the hospitalist and the physician leadership partnership worked with the administration to develop goals that were aligned with the system’s quality goals. They were also given the opportunity to see bonus payments based on quality outcomes.
However, the goals being developed needed to be realistic advancements in quality metrics, not gimmies. They needed to be measurable – based on valid and timely data – and be aligned with the system’s objectives to bring value to the system. This was an organization – like all healthcare organizations to some degree – looking to reduce length of stay, reduce unnecessary emergency department (ED) visits, lower readmission rates, etc. With several of these goals in mind, the team selected a leader for each aim, and this leader helped develop action plans to see it through.
This entire process was very transparent. The hospital and administration were able to utilize dashboard reporting on a continual basis. Such reporting tracked outcomes in terms of quality, and the impact on the system. This ultimately confirmed the result as a win-win for everybody. Bottom line, there was a highly engaged provider group aligned and supportive of the health systems quality initiatives.
Real Example of What Can Happen When Physicians are Not Engaged
It is so important to engage physicians in initiatives early on – even for construction plans. To skip this step can lead to costly oversights. For example, a facility construction project for a very large multi-specialty practice was underway. The initial stakeholders in the project are who you might expect; administration, architects, engineers, and procurement. All stakeholders on the team were very intelligent and highly capable.
Partway through the construction of the facility, someone suggests, “Maybe we should have the providers – the people who will be working in this building – look at the progress. Maybe we need to get their input.” The construction was about 50% completed at this point. From the providers’ feedback, the design was found to be less than optimal for the providers. Flaws were pointed out with sink location, patient flow, and the workstation’s design and location. Electrical outlets could have had better placement as well.
Getting physician feedback well before you break ground can help you avoid unfortunate missteps. Anyone who has been involved in construction knows that change orders create delays in the project and are also expensive. This served as a lesson to gather physician input in the beginning when plans are being drafted.
Conclusion
Physician engagement is a critical factor for any major initiative within a health system, It can help create momentum, generate buy-in and the cultural alignment needed to ensure a successful outcome. It is also crucial to know which providers are the formal and informal leaders within the organization.
Coming in as an outside consultant, it is important to engage not only with your C-Suite but also to – whenever possible – loop in those operation managers at the practice level. This uncovers who the true influencers are amongst your provider team.
You need to engage these champions early on at the conceptual stage of any initiative. You need to be prepared to explain the why behind what’s taking place. The more you clearly articulate to the provider team what you’re doing and what the rationale is behind it, the better. Finally, emphasize that – to be successful in this initiative – the physician champion must be part of the solution.
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Full Episode Transcript
Medical Advantage Podcast: Welcome to the Medical Advantage Podcast, where you can hear healthcare professionals, expert consultants, and industry thought leaders discuss the exciting new ideas and technologies that are changing the business of healthcare. Tune in to each episode as we hear from some of the most innovative minds in medicine about the future of healthcare and how your organization can stay profitable, efficient, and on top of industry best practices.
Celina DeFigueiredo-Dusseau: Welcome everyone to the Medical Advantage podcast series. I am your host, Celina Dusseau, and today we are joined by Monty Pate our Executive Healthcare consultant here at Medical Advantage. For those of you new to our podcast and new to us Medical Advantage is a healthcare services company. We provide a broad portfolio of services for medical practices, specialists, groups, and private equity.
Today we will discuss the importance of physician engagement in growing strong and growth oriented healthcare entities. We will seek to understand what is physician engagement, identifying physician leaders and the impact physician champions can have on any medical practice. We will discuss the critical role physician representatives and leadership play in any healthcare organizational change, including operational transformation, mergers and acquisitions, and overall governance and strategic success.
We will address how engaged physicians promote alignment and help maintain traction throughout all enterprise initiatives. Acknowledging these impacts helps us embrace the benefits of physician leadership and frame a growth strategy that meets and hopefully exceeds the needs of patients, providers, and medical staff alike.
Monty, thank you for joining us.
Montgomery Pate: Thank you.
Celina DeFigueiredo-Dusseau: So to get us started, I’d like to understand from your perspective, Monty, what has brought about this conversation today? What is the role of physician engagement in the modern healthcare landscape?
Montgomery Pate: Certainly Celina. From my experience, I have seen physician engagement serve as an essential ingredient for any major initiative that’s being developed and ultimately implemented by a health system. In essence, it’s a change agent that can create momentum and bring about a cultural alignment supporting the initiative.
Celina DeFigueiredo-Dusseau: Thank you. So to set the stage for our discussion, it would be great to define exactly what physician engagement means for the purposes of this discussion. Can you give us a definition and maybe an overview of what all that might encompass?
Montgomery Pate: Absolutely Celina. Physician engagement means having a supportive, influential and vocal advocate who represents the interests of his or her peers, i.e. the providers for any transformational project. It means having designated providers who participate as good faith partners in the development and rollout of initiatives, and that can include a wide variety of projects.
Anything from new EHR implementation, construction projects, compensation models consulting or private equity engagement, patient workflow, and even provider recruitment.
Celina DeFigueiredo-Dusseau: That is wonderful. Thank you, Monty. And as I’m sure we all know, and as you’ve already alluded to in the examples above, this idea of physician engagement can take many forms based on need and organizational structure. Can you help put some framework around who might fill the role of a physician champion? Or what does an engaged physician look?
Montgomery Pate: Certainly Celina, ideally, you’re looking for providers who have a broader understanding and appreciation for all of the elements that make up the healthcare enterprise. Things such as budget, staffing, patient engagement, brand loyalty, informatics, compensation models, quality, telehealth you’re looking for somebody that has that global perspective with regard to healthcare.
You’re also looking for providers who are willing to be part of the solution and work with other stakeholders in a truly collegial and collaborative manner. This can manifest either by being part of committees or working groups, and you certainly want somebody who’s gonna be willing to provide frank, honest, and certainly constructive communication and input. And while doing so, keeping in mind the best overall interest of the health system.
You want to find providers who are obviously well respected amongst their peers, but also providers who are willing to communicate at the peer-to-peer level regarding the strategies and initiatives that they’ve participated in developing. And whenever possible on these type of engagements, you’re looking for providers from diverse practices, i.e., primary care and specialty care.
Celina DeFigueiredo-Dusseau: That is a great perspective. You are spot on that this not only reflects expertise and knowledge, but the willingness to dedicate time and creativity to solutions, both through providing ideas, championing acceptance of change, creating learning opportunities for staff.
It isn’t just about knowing what can be improved, but demonstrating that thought leadership and sharing those ideas and truly serving as a leader all the way through implementation and maintenance. Which makes me wonder, why does this all matter? Why is the presence of an engaged physician so impactful versus other leadership roles and models within many organizations?
Montgomery Pate: Yeah, that’s a great question, Celina. And it matters for a number of reasons. First of all, providers bring a unique perspective regarding the initiative impact on the delivery of care. They’re obviously closer to the patient and more directly involved in the delivery of care. So they bring that perspective to the engagement.
Providers as a group also want to be heard and they want to know that their input matters. Also a provider advocate or champion can really bring credibility to the project. It’s one thing for C-Suite or administration to talk about initiatives or plans, but to have a provider champion that’s aligned and supportive of those plans only help to align the the organization in the long run.
The other thing is, by their nature and training, providers want to understand the why behind any given project, and this is a good thing because consultants and administration need to be able to articulate the why behind what they’re doing. The other part in terms of why it matters and sometimes this can be a little painful on the front end, but providers by their training will look to challenge gaps in logic. They’ll challenge assumptions, and that really forces the stakeholder to reconcile these concerns early on in the process.
And that is ultimately, a good thing. On the flip side of this, if you fail to engage your providers, you can create a rumor mill within the organization. If they’re not sure what’s occurring or why it’s occurring, it’s just human nature to have a fear of the unknown. There’s also that old cliche of, “there they go again.” Meaning this is another initiative that’s being launched without the input of the providers.
And finally, if you fail to engage your providers again, you’re really missing out on that critical provider perspective.
Celina DeFigueiredo-Dusseau: Precisely, Monty. It’s more than just their training, but everything that a physician has to experience to be a good provider through their work.
So many leadership skills and perspectives are practiced that provide that invaluable perspective of both patient care and C-suite level problem solving knowledge, which as we know, takes a great deal of expertise, adaptability, and growth interest. It’s not easy to acquire that expertise, let alone repurpose it.
For the interest of organizational performance. Developing a strategy for this can be quite daunting. So from your experience, Monty, where would you recommend that an organization starts?
Montgomery Pate: Well, my starting point would be with the C-suite, your CEO, your COO, the folks in the front office. If they have been in their position for any length of time, they should know their provider team. And by knowing the team, they need to know not only who the formal leaders are within the organization, but also the informal leaders. These people may not have a title such as director or chairman, but they’re the ones that the other providers and staff look to. Your C-Suite as well should know who the providers are that are collaborative by nature, as well as the ones that see the big picture of healthcare enterprise.
And finally, you want to really leverage that C-suite understanding in terms of identifying providers who want to be part of the solution, we’re all guilty of stepping back and casting stones at a problem or something we don’t like. But what you really need are providers who are willing to roll up their sleeves, be a part of the solution, and come along on the journey.
You need to begin these discussions at the conceptual stages of any initiative, and you do that early on to assess a willingness to participate.
Celina DeFigueiredo-Dusseau: Monty, that’s such an important point, is engaging those who understand the need for engagement and see it from the larger picture, but most importantly, have that innate nature to collaboratively problem solve and want to be part of the group solution.
I’m sure from your vast experience that you’ve seen quite a variety of champion teams. Likely some who have performed, say better than others. I would love to hear a bit more about what you’ve seen in the field. So could you share an example or two of what has fostered a positive outcome through physician leadership?
Montgomery Pate: Certainly Celina. I had the good fortune of working with a very large employed hospitalist group for a major health system in the South, and the leadership in the health system were looking for a way to incentivize those hospitalists to support the system’s quality goals, if you will. The administration communicated the why and the general concept was to move the needle on the quality outcomes.
They realized that the hospitalists have a great impact on inpatient quality. But they were also looking to create a physician compensation model and bonus structure that tied to those quality metrics that aligned with the systems quality initiatives, ultimately creating a win-win. A win for the providers, and a win for the system.
The hospital leaders got this information. It was very well laid out and articulated. And the first thing that the hospitalist leadership did was solicit input from all the providers on their team. And this was a group of about 80 or so hospitalists spread out over four different campuses.
Then the hospitalists, the physician leadership, worked in partnership with administration to develop goals that again, aligned with the systems quality goals, but also gave them an opportunity to see bonus payments based on quality outcomes. So the goals that were being developed, they needed to be realistic advancements on quality metrics, not gimmes. They needed to be measurable with valid and timely data, as we said, they needed to be aligned with the system objectives and they needed to bring value to the system.
This was an organization, like probably all healthcare organizations to some degree, that are looking to reduce length of stay, reduce unnecessary ED visits, lower readmission rates. And with the goals, there was probably a half a dozen of those, the team selected a for each of those goals and that leader helped develop action plan.
To see this through, and I will mention here, a very important part of this is that this entire process was very transparent. The hospitalists and administration were able to utilize dashboard reporting on a continual basis to show the outcomes in terms of quality and the impact to the system.
And ultimately it was seen as a win-win by everybody. And you had at the end of the day, a highly engaged provider group who were aligned and supportive of the health system’s quality initiatives.
Celina DeFigueiredo-Dusseau: This is great Monty. Having the physicians be engaged but still trusting in the leadership capabilities and growth of the team really seems to have had quite an impact on the success of this initiative.
Serving as the champion does not mean that all of the burden is on the physician. They serve to understand the problem, the bigger picture, and empower their amazing team to enact and see through those changes. Now on the flip side of the coin, I’m curious to hear what experience you’ve had where maybe this process didn’t quite go as planned. What challenges might you run into? A cautionary tale, if you will?
Montgomery Pate: Well, certainly. A cautionary tale I’ve had, during my career I’ve had the opportunity to be involved in several construction projects, medical facility construction. One in particular comes to mind, and this was early on in my career. It was a facility construction project for a very large multi-specialty practice, and the initial stakeholders in the project are who you might expect it was, administration, of course, architects, engineers, procurement, IT, all of these people, very intelligent, very good at what they do. And the construction project began.
It was a project that was well underway until somebody thought, maybe we should have the providers, the people actually working in this building, take a look at it. Maybe we need to get their input. And keep in mind the project was probably 50% of the way towards completion. Once the providers were brought in, we learned some very valuable things about the layout and the design and specific things within the design that were not optimal for the providers.
Things like sink location, patient flow, workstation design and location. Even electrical outlets, small things like that. If you’re not taking the provider’s point of view into consideration it can ultimately come back to bite you. And in this case, it created a great deal of rework. And if you’ve ever been involved in construction you know, change orders create delays in the project, but they’re also expensive.
So that was a great lesson learned. And you know, I think it’s had an impact, in my career and I always try to be mindful of that going forward.
Celina DeFigueiredo-Dusseau: Right, and knowing those obstacles or those potential obstacles and troubles can often be the best place to start to really ensure that initiative is successful in the future for any project that impacts providers, which is most anything within a healthcare delivery system.
They need to be engaged at the beginning of the conceptual exploration for any initiative. You cannot do this too soon in project planning. As we begin to wrap up here today, Monty, do you have any final thoughts to share with our listeners?
Montgomery Pate: Well, I would say the following, engagement is a critical factor within any major initiative within a health system. It can help create momentum, buy-in, and the cultural alignment needed to ensure a successful outcome.
Also, I would say know your providers. Who are the formal, as well as informal leaders within the organization? If you’re coming in as an outside consultant, engage not only with your C-suite. But if possible, those operation managers at the practice level to really learn who the true influencers are amongst your provider team.
You need to engage these champions early on, as you’ve said, at the conceptual stage of any initiative. And you need to be prepared to explain the why behind what’s taking place. And that is a valuable thing to be able to clearly articulate to the provider team what you’re doing and what is the rationale behind it.
And finally, I would say when you engage your providers, make sure it’s clear that they are being asked to be part of the solution.
Celina DeFigueiredo-Dusseau: Thank you, Monty. I think the biggest takeaway here is that physician engagement creates value for whatever the undertaking might be, whether it’s a private equity transaction, a consulting engagement, or an internal project within the healthcare enterprise.
Gaining that element of understanding and trust from your physicians is a critical success. You cannot start the conversation too soon with your physician leaders. Thank you Monty so much again for your time today, and thank you always to our audience for listening. See you next time.
Medical Advantage Podcast: Thanks for joining us this week on the Medical Advantage Podcast where we discuss the ideas and technologies changing healthcare and what they mean to your organization. For more information, visit us at medicaladvantage.com and make sure to subscribe to the podcast on iTunes, Spotify, or wherever you get your podcast, so you never miss a show.
